Head to Toe Guide: Women’s Health

No matter what your age, having a clean bill of health is one of the most important things you can attain. Each stage of life presents different health issues for women, but as long as you are aware of your current state of health and see your physician on a regular basis you should be able to head off any problems you might develop.

Assessing your health on a yearly, monthly and sometimes weekly basis is essential to help you live a long and healthy life. Don’t assume that a simple yearly check-up is enough. Some screenings may require more attention than others, and your current health status, age, genetic issues and diet can make a big impact on whether or not you pass your screenings with flying colors.

“Women today have multidimensional and demanding lives,” says Kenneth Brigham, MD, director at Emory-Georgia Tech Center for Health Discovery and Well Being. “When a woman takes time to understand her personal health profile, she can also learn more about approaches that can help her restore, maintain and optimize health. Developing a personal health plan and setting realistic goals can help a woman find balance, including making time to relax, eat healthy and keep moving.”

Your Bones

Having strong bones is not only a concern of women in their 40s and 50s. Young adults in their 20s and even teens are becoming more aware of how important bone health is through different programs and initiatives like Best Bones Forever, which was launched in 2009 by the U.S. Department of Health and Human Services. This year, a resolution in the Michigan House of Representatives was passed declaring October 20, 2011 as Osteoporosis Awareness and Prevention Day. According to the National Osteoporosis Foundation (NOF), “In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone density, placing them at increased risk for osteoporosis and broken bones. Of those 10, eight million are women.”

Whether or not you suffer from osteoporosis or other bone degenerative diseases, a bone density test, also called densitometry or DXA scan, should be at the top of your list. Before the invention of this test, osteoporosis was detected only if and after you broke a bone. Today’s test uses X-rays to measure how many grams of calcium and other minerals are inside a segment of your bone. Besides testing for osteoporosis, these scans can also determine your risk of fractures or broken bones as well as any decreases in bone density.

Beyond just the X-ray, some women may be required to do a bone scan, which involves an injection before getting started. This is only necessary to detect bone cancer, infections or other abnormalities. If weak bones run in your family or you are experiencing skeletal pain, this is a test you may want to ask your doctor about. The bottom line is you are never too young or too old to improve the health of your bones.

Take Action!

Pay attention to your calcium and vitamin D intake. According to the CDC, if you are in the age range of 19 to 50 your recommended daily calcium intake should be 1000 mg. For women 51 or older, it is 1200 mg. Also, engage in at least 30 minutes of moderate exercise a day to keep your bones strong.

Your Breasts

One of the most important parts of a woman’s health care routine should be a self-breast exam. This early form of detection of abnormal lumps is crucial and life-saving. “Clinical breast exams begin at age 20 with follow-ups every three years,” says Sara Mobasseri, MD, Medical Director of Women’s Heart Services at Piedmont Heart Institute. “Those with a family history of breast cancer or other risk factors should get their first screening mammogram at age 35, otherwise they should begin at age 40.”

Although strides are being made to prevent and treat breast cancer, it is still a prevalent disease and one that needs to be at the forefront of a woman’s mind when it comes to her health. According to BreastCancer.org, it is estimated that about one in eight women in the United States (12%) will develop invasive breast cancer over the course of her lifetime. In 2010, there were more than 2.5 million breast cancer survivors in the U.S.

There are many different factors that affect the chances of a woman developing breast cancer including age, genetics, (about 5% to 10% of breast cancers are thought to be hereditary, according to BreastCancer.org), being overweight and exposure to chemicals in plastic such as bisphenol A (BPA) just to name a few. With the development of BRAC Analysis, this genetic test is said to help identify your risk for hereditary breast and ovarian cancer syndrome (HBOC), an inherited condition that raises the risk of developing certain cancers.

With all the resources and support systems out there, women have the power to educate themselves. Being armed with knowledge and facts about breast health is the first step toward the first step toward staying healthy.

Take Action!

Limit alcohol. The more alcohol you drink, the greater your risk of developing breast cancer. If you choose to drink alcohol — including beer, wine or liquor — limit yourself to no more than one drink a day.

Be aware of hormone therapy. Long-term combination hormone therapy may increase the risk of breast cancer. If you are on hormone therapy for menopausal symptoms, ask your doctor about other options.*

*Due to a study reported in The New England Journal of Medicine that links hormone therapy to breast cancer, the Food and Drug Administration recommends that women who want to take hormones only do so at the lowest dose and for the shortest possible time.

Control your weight. Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause.

Get plenty of physical activity. Being physically active can help you maintain a healthy weight, which, in turn, helps prevent breast cancer. If you’re just starting a physical activity program, start slowly and build intensity gradually.

Avoid exposure to environmental pollution. While further studies are needed, some research suggests a link between breast cancer and exposure to the polycyclic aromatic hydrocarbons found in vehicle exhaust and air pollution.

-Courtesy of Mayo Clinic

Your Pelvis

Keeping healthy below the belt involves being aware of any discomfort you may be experiencing. In addition to daily exercise and a good diet, pelvic screenings, exams and pap tests are invaluable in locating potential problems. Regular pap tests can find abnormalities and early detection is key to treating issues successfully.

Health concerns involving this area can vary widely. While some pelvic health issues center around problems with bladder control, urinary incontinence and bowel incontinence, others can involve cancer of the cervix. Factors that may contribute to these concerns include childbirth, obesity, menopause, stress, straining during bowel movements and older age. Half of women over age 50 experience pelvic floor weakening (urinary incontinence and fecal incontinence), according to Mayo Clinic Women’s HealthSource. Treatments for pelvic floor dysfunction include physical therapy, medical treatments, acupuncture and, in some cases, surgery.

Cervical cancer was once one of the most common causes of cancer death for American women. Once the pap test became more commonly used, the death rate declined by almost 70%. According to the new American Congress of Obstetricians and Gynecologists (ACOG) guidelines, women aged 21 to 30 years should be screened every two years using either the standard pap test or liquid-based cytology. Women 30 years and older who have had three consecutive negative (i.e., normal) cervical cytology test results may be screened once every three years with either screening test. Women older than 30 years can also be co-screened with a combination of the pap test and an HPV test.

In addition to taking notice of your pelvis area, you should also be aware of your colon. “At age 50, a woman should begin regular colonoscopies and repeat every five years,” advises Mobasseri. “Again, with a family history of colon cancer or other risk factors present, these screenings should begin at age 45. Age should not be the only indicator in preventative health care in women. It’s important for all women to know their family history and risk factors and to talk about these with their doctor.” Whether you opt for the non-invasive virtual colonoscopy, a sigmoidoscopy, (a procedure in which a lighted tube and camera are inserted), or a colonoscopy, which involves a longer tube to examine the entire area, it is important to get one done.

Take Action!

The HPV vaccine. There are approximately 40 types of genital HPV. Some types can cause cervical cancer in women and can also cause other kinds of cancer in both men and women. The HPV vaccine works by preventing the most common types of HPV that cause cervical cancer and genital warts.

-Courtesy of the National Cancer Institute and the Center for Disease Control

Your Hormones

There are many different aspects that can affect hormone health such as your diet, exercise regimen and age. Typically, the issue of hormone health comes up as a woman approaches menopause and directly afterward. Whether or not you need hormone replacement therapy (HRT) is a personal decision and one that should be made after considering all the facts.

“Starting hormone therapy requires evaluation by a physician with focus on endocrine function. Personal history, symptoms, family history, physical exam and certain laboratory tests should be reviewed, as well as extensive discussion about the risk and benefits of the therapy,” advises Ceana Nezhat, MD, FACOG, FACS Gynecologist Chair of the Department of Obstetrics and Gynecology, Northside Hospital. “Many of the symptoms that we associate with menopause can be addressed and treated. Currently, there are many different combinations and forms of hormones and the therapy must be tailored to the individual.”

Nezhat goes on to explain that there are many medical conditions that require the use of hormones such as diabetes, thyroid conditions, adrenal insufficiency, and female sex hormone imbalance due to malfunction or lack of ovarian function. Certain clues that hormone therapy might be indicated include changes in weight, hair loss, changes in mood, sexual desire, acne, fatigue, abnormal uterine bleeding, dry skin, and vaginal dryness.

“When re-establishing optimal hormone levels, it is important to consider the source. Bio-identical hormones, from natural sources have the exact same molecular structure as the ones we produce, making them easily recognizable and usable,” explains Sharon Bent-Harley, MD of Harley Anti-Aging Institute. “Synthetic hormones, on the other hand, do not have this same structure and would not be expected to impact cells in the exact same manner as bio-identical hormones.”

In 2002, a government-funded study called the Women’s Health Initiative did a study on HRT and found certain risks, such as cancer, to be linked to long-term use of this therapy. They advise that women with breast cancer, heart disease, liver disease, or a history of blood clots are not candidates for HRT. If you are considering HRT for yourself, make sure you check with a physician before beginning any type of treatment.

Your Vitals

Practically every check up begins with an evaluation of your vitals, and rightfully so. Your blood pressure, cholesterol, weight and other important numbers all have a monumental effect on the rest of your body. Don’t overlook these important screenings, and instead make them your top priority, even if you feel you are leading a healthy lifestyle.

Blood Pressure ScreeningIdeal blood pressure for women is less than 120/80 mmHg (millimeters of mercury). Get tested at least every two years if you have normal blood pressure (lower than 120/80). Get tested once a year if you have blood pressure between 120/80 and 139/89. Discuss treatment with your doctor or nurse if you have blood pressure 140/90 or higher.

Cholesterol CheckHave your cholesterol checked at least every five years starting at about age 20. “It is important to note that acceptable cholesterol levels for women are slightly different than those for men. Total cholesterol count should be less than 200 mg/dl. LDL (“L” for bad or lethal cholesterol) should be less than 100 mg/dl, while HDL (“H” for good or healthy cholesterol) should be 50 mg/dl or higher and triglycerides lower than 150 mg/dl.,” explains Mobasseri.

Blood Glucose TestHave a blood glucose test every three years starting at age 45 to test for diabetes or pre-diabetes. If you are already showing signs or symptoms of diabetes, or if it runs in your family, you may want to get tested before 45.

Skin ExaminationBy age 20, your doctor or dermatologist should be performing routine check-ups on moles, spots or freckles to check for early signs of cancer. Wearing UV protection in the form of clothing or creams is also a good way to help prevent skin cancer.

Your Health

In the end, it’s up to you to keep an eye on the signs your body is showing you. Don’t wait for a discomfort to turn into something bigger. “Some risk factors that you have little or no control over include family history of a disease, age, ethnicity, and a health problem that can raise the risk of another problem,” says Brigham. “Some risk factors you can control include what you eat, how much physical activity you get, whether you use tobacco and how much alcohol you drink. Awareness of these factors is crucial in developing a healthy plan of action for a lifetime.”

If you haven’t already, try forming a health care plan today – include an exercise program, diet evaluation and a look into your family’s health history. Need some extra help? Try talking to a nutrition coach or wellness guide who can help point you in the right direction. “On a daily basis, every woman from the teens to the 80s should be concerned about disease prevention by getting enough sleep, enough exercise and enough vegetables/fruit and anti-oxidants in their diets,” advises Eva Arkin, MD at Premier Care for Women.

Whether you’re in your 30s, 40s, 50s or beyond, each stage of your life presents different health challenges. The best thing to do is meet them head on, educate yourself and maintain an active lifestyle both mentally and physically.

Spotlight on Breast Cancer

Whether you sport pink or participate in an event, there are so many ways to show your support for Breast Cancer Awareness Month. Here are just a few:

Read PinkBreastcancer.org and Stonyfield Farms have paired up to create a global breast cancer prevention initiative, Think Pink, Live Green. This global outreach includes Marisa C. Weiss, MD’s column, a step-by-step guide to reducing your risk of breast cancer, presentations to women around the country and the Lower Your Risk section of Breastcancer.org. www.livegreen.breastcancer.org

Enjoy a Sweet TreatVisit any Yogli Mogli store during the month of October and enjoy pink yogurt! Yogli Mogli is donating a portion of proceeds from all sales to breast cancer. www.yoglimogli.com

Wear the BraceletHonesty Jewelry will be selling a special bracelet for Breast Cancer Awareness Month. All proceeds will go to the Susan G. Komen Foundation. www.honestyjewelry.com

Cafe Circa’s Breast Cancer Awareness Month MenuCafe Circa is offering a three-course healthful meal for $25 throughout the month of October. These meals are packed full of antioxidants to help fight cancer. (404) 477-0008, www.cafecircaatl.com